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Some injectable fertility medications increase your levels of the pregnancy hormone, human chorionic gonadotropin (hCG). Ovarian hyperstimulation syndrome (OHSS) develops when the blood vessels in your ovaries have an abnormal response to the presence of hCG and leak fluid. The condition is characterized by pain and swelling in the ovaries and sometimes the abdomen.

What is Ovarian Hyperstimulation Syndrome?

Once considered a more common complication of IVF, OHSS cases have declined over the years. It currently affects less than 5% of all those who undergo the fertility treatment. Less than 1% of all individuals pursuing hormonal fertility treatments experience severe OHSS.

Let’s take a look at what causes this relatively rare IVF complication and how to prevent it during your cycle.

OHSS most often occurs as the result of injectable fertility medications used to stimulate egg growth and trigger egg release during IVF or egg freezing. Oral fertility medications are a less common cause of OHSS. It may also develop spontaneously in rare cases.

The following factors may increase your risk for OHSS, but they aren’t necessary for it to develop.

If you experience OHSS during one round of fertility treatment, you may be more likely to experience it again.

When OHSS develops during IVF, symptoms typically appear within a week of the first injection of stimulation medication. However, it may take two weeks or more for symptoms to develop.

Symptoms vary by the severity of the condition. Mild to moderate cases often include mild abdominal swelling, bloating, and nausea, as well as minor weight gain.

More severe cases include severe abdominal pain and swelling, bloating, and nausea, and much more noticeable weight gain. Difficulty breathing, blood clots, decreased urination, and impaired kidney function can also occur in these cases.

While the majority of OHSS cases are mild and don’t require treatment, tell your healthcare provider about any potential symptoms. They will require monitoring regardless of their intensity.

Without prompt, effective treatment, severe cases of OHSS can lead to serious complications, including a blood clot in the lungs or legs, or a ruptured ovarian cyst. Seek immediate care from your provider if at any point during your fertility treatment you have trouble breathing or feel pain or swelling in your legs or chest.

Doctors may recommend gonadotropin-releasing hormone (Gn-RH) antagonists or letrozole to treat moderate to severe symptoms of OHSS. These medications suppress ovarian activity.

In some cases, a doctor may recommend canceling treatment and starting a new cycle in the future after OHSS symptoms have resolved. Although this can be devastating, remember that many individuals and couples have eventual success with IVF after one or more canceled or unsuccessful cycles.

It may be an option to freeze embryos from IVF and finish the implantation at a later date after your body has recovered from OHSS.

Fortunately, there are steps you can take to lower the risk of OHSS during IVF. If you have any known risk factors, or if you experienced OHSS during a previous cycle, your provider may recommend one or more of the following adjustments to your treatment plan.

A medication called cabergoline is primarily used to prevent cases of OHSS during IVF. GnRH antagonists and letrozole are sometimes also used as preventative treatment.

Metformin — an oral diabetes medication that is sometimes used off-label to treat PCOS — can also be used to reduce the risk of OHSS in women with PCOS.

If you have high levels of estrogen or many developed follicles during IVF, your doctor may adjust the timing or duration of your medication schedule. A common practice is to stop the use of stimulation medications for several days before the trigger shot(s) to prevent further stimulation of a high follicle count.

Injecting the lowest effective dose of a fertility medication can also help prevent OHSS.

Your doctor may also recommend using an alternative medication such as leuprolide in place of an hCG trigger shot to prevent OHSS.

Choose a flexible and reliable pharmacy partner

Fertility treatment can be challenging, but we’ll be with you every step of the way. To ensure that your treatment plan is followed correctly, we offer free same-day delivery of your medications and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

Interested in learning more about how Alto can support your fertility treatment? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Antiviral medications have fueled many medical breakthroughs since they were first introduced in the 1960s to treat viruses. Not only are they currently helping to reduce severe cases of covid-19 and related hospitalizations, they have also made HIV a manageable chronic condition — and that’s only to name a few examples of the role they play in healthcare.

How Do Antiviral Medications Work?

Antiviral medications have fueled many medical breakthroughs since they were first introduced in the 1960s to treat viruses. Not only are they currently helping to reduce severe cases of Covid-19 and related hospitalizations, they have also made HIV a manageable chronic condition — and that’s only to name a few examples of the role they play in healthcare.

Take a look at how these medications treat and prevent viruses like Covid, the flu, HIV, hepatitis, and more. 

A virus is a germ that causes an illness. It cannot survive on its own. In order to replicate and spread, it must infect healthy cells in your body.

Well-known diseases caused by viruses include:

Viruses are distinct from bacteria. While antibiotics are highly effective at ending infections caused by bacteria, they cannot work on viruses. This is why the creation of antivirals was such an important medical advancement.

Antiviral medications help your body fight a virus by disrupting the infectious agent’s replication process. They function differently depending on which virus they’re targeting. When used to treat the flu or Covid, for instance, they can reduce the severity of symptoms and shorten the duration of the infection.

When treating chronic illnesses like HIV or herpes, antivirals cannot permanently end the infection. Rather, they lower the amount of the virus in your body — also referred to as your viral load — to control symptoms and prevent transmission.

When taken as prescribed every day, the antivirals used to treat HIV can help those with the condition maintain an undetectable viral load. This stops the progression of the illness and virtually eliminates the risk of transmitting it to others.

While they are not a substitute for vaccines, antivirals can also be used as a preventative measure against some viruses, as explained in more detail below.

The majority of antivirals are oral medications, but they can also be taken as an injection, intravenously, topically, or even as eye drops or an inhalant.

Many antivirals can safely be used by children as well as pregnant and breastfeeding individuals. Guidelines vary by medication. Consult with your provider about whether a specific antiviral is an option for you.

The duration and starting point of antiviral treatment varies by virus.

Tamiflu® and Paxlovid®, which treat the flu and Covid, respectively, are typically prescribed for several days. In some cases, it’s necessary to take them for a week or more.

These medications are most effective if taken within two days of infection. However, it may still be beneficial to take them after two days, especially if you are at risk for complications.

The following factors may increase your risk of complications from the flu and/or Covid.

Respiratory conditions such as chronic obstructive pulmonary disease (COPD)

Weakened immunity from illness or medications

Age - adults 65 and older and children under two are most vulnerable

The antivirals used to treat the Ebola virus — Inmazeb® and Ebanga® — are administered as a single intravenous infusion.

When used to treat chronic conditions such as HIV, hepatitis B or C, or herpes, antivirals must be taken on an ongoing basis, even in the absence of symptoms.

If you have received a diagnosis of a chronic condition caused by a virus, it’s important to begin treatment as quickly as possible to protect your health and others.

Some antiviral medications can protect against viral infections after potential exposure. PEP, or post exposure prophylaxis, is a medication taken within 72 hours of potential exposure to HIV to lower a person’s chances of contracting the virus. There are other medications that work similarly after potential exposure to the flu.

Antivirals may also be prescribed for individuals with HIV during pregnancy to prevent transmission from mother to baby. The baby will also likely receive antiviral treatment after it is born.

While some antivirals can prevent a person from getting infected by a virus after potential exposure, they are not a substitute for vaccines, which offer ongoing protection against viruses. 

Additionally, while other antivirals reduce the severity of symptoms, vaccines are even more of a safeguard against virus-related health complications, as they prevent the initial infection altogether.

Check with your doctor about which vaccines you need. For detailed vaccine recommendations by age group, reference the CDC’s recommended immunization schedules for children and adolescents and adults.

Managing any chronic condition is easier with a reliable pharmacy partner by your side. Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started and stay on track with antiretroviral therapy as well as the preventative medication PrEP.

We will coordinate with your healthcare and insurance providers to ensure that you’re receiving the best option for your needs at the best price. Our pharmacists are also available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through in-app messaging or by phone at 1-800-874-5881.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Take a look at how antiviral medications treat and prevent viruses like covid, the flu, HIV, hepatitis, and more. Read on here.

While many people who suffer a heart attack are able to experience a full and active life after recovering, it often takes time to get back on your feet. And given the risk of another heart attack — about 1 in 5 of those age 45 and older have a second one within five years of their first — it’s important to prioritize your health and stay proactive about prevention efforts.

Medications Used After a Heart Attack

Recovery looks different for each person, with treatment dependent upon a variety of factors including the type of heart attack you had, its severity, and your overall health history. In most cases, a combination of lifestyle changes and medication is necessary to manage the risk of another heart attack. Here’s an overview of what to expect.

A heart attack occurs when blood flow to the heart is reduced or blocked as the result of a blockage in a coronary artery. There are two main types of heart attacks, categorized by the extent of the blockage:

An ST-elevation myocardial infarction, commonly referred to as a “STEMI” heart attack, is caused by a complete blockage.

A non-ST-elevation myocardial infarction, commonly referred to as an “NSTEMI” heart attack, is caused by a partial blockage.

Coronary artery disease, the most common type of heart disease, is the cause of most heart attacks. In this condition, accumulation of plaque causes the coronary arteries to become hardened or blocked.

Too often, people learn that they have coronary artery disease after having a heart attack. To detect cardiovascular issues at an early stage, consult with your doctor about your risk for heart disease. Your doctor may use a cardiac risk calculator to assess your chances of developing heart disease based on your personal health history.

Remember that your risk can be managed. The purpose of calculating it is to help you take important preventative steps. While some drivers of heart disease like age and genetics aren’t modifiable, you have control over many others, including high blood pressure, high cholesterol, smoking, and physical inactivity.

Presentation of heart attack symptoms can vary significantly from one person to another. In fact, not everyone who has a heart attack develops symptoms. When they do occur, they can range from mild to severe, developing suddenly or over the course of days or weeks. 

If you think you might be having a heart attack, seek medical care right away. Chest pain or pressure is the most common symptom for both men and women, but watch for the following signs as well.

There is some variation between men and women in the presentation of a heart attack. The symptoms marked with an asterisk (*) are more common in women.

The timeline for heart attack recovery ranges from two weeks to three months. Treatment typically includes lifestyle changes, medication, and cardiac rehabilitation. Surgical procedures may be necessary to treat more severe cases.

It’s important to actively participate in your health after a heart attack. Recovery care and prevention should be a collaborative effort between you and your care team. Stay on track with your appointments. The American Heart Association recommends visiting your doctor for a follow-up appointment within six weeks of your heart attack.

Many people find enrolling in a cardiac rehabilitation program to be beneficial for heart attack recovery. These programs offer access to expert healthcare professionals who can support you in making changes to your routine and managing stress. Speak with your doctor about whether cardiac rehabilitation is a good fit for your needs. 

Your doctor may advise you to change health habits after a heart attack. For many people that includes: 

Avoiding cigarette smoke and limiting your alcohol intake

Medications prescribed after a heart attack

The primary goal of post-heart attack care is to reduce the risk of another heart attack. A variety of medications may be prescribed to:

Prevent complications such as arrhythmias, blood clots, and heart failure

These are the most commonly prescribed medication classes.

Anticoagulants reduce the blood’s ability to form new clots and prevent existing clots from growing. Commonly prescribed anticoagulants include:

Warfarin (Coumadin®, Jantoven®), which prevents the liver from processing vitamin K into proteins that help form blood clots.

Direct oral anticoagulants (DOACs) such as apixaban (Eliquis®), betrixaban (Bevyxxa®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®), which directly block the blood’s ability to form clots.

Like anticoagulants, antiplatelets prevent blood clots from forming. They accomplish this specifically by preventing blood platelets from sticking together. Commonly prescribed antiplatelets include:

Frequently used to lower blood pressure, ACE inhibitors block production of a hormone called angiotensin II, which causes blood vessels to narrow, so that more blood can flow through. Commonly prescribed ACE inhibitors include:

Angiotensin II receptor blockers (ARBs) also protect blood vessels from the hormone angiotensin II to lower blood pressure. Commonly prescribed ARBs include:

Beta blockers cause the heart to beat more slowly and less forcefully, lowering your blood pressure. They also help improve overall blood flow by opening up your veins and arteries.

Commonly prescribed beta blockers include:

Beta blockers typically aren’t recommended for those with asthma, as they can trigger severe asthma attacks.

Never stop taking a beta blocker without first consulting with your doctor. Abruptly stopping the use of these medications can increase the risk of heart attack.

Alpha-beta blockers combine alpha and beta blockers to decrease constriction of blood vessels and help the heart work less forcefully.

Commonly prescribed alpha-beta blockers include:

Also used to lower blood pressure, calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels. This opens up narrowed blood vessels and eases the heart’s workload.

Commonly prescribed calcium channel blockers include:

Diltiazem (Cardizem CD®, Cardizem SR®, Dilacor XR®, Tiazac®)

Verapamil (Calan SR®, Covera HS®, Isoptin SR®, Verelan®)

The most common cholesterol-lowering medication, statins act on the liver to prevent cholesterol from forming. Commonly prescribed statins include:

If statins aren’t the best option for you or your cholesterol levels need to decrease further, your doctor may prescribe a non-statin cholesterol medication such as ezetimibe (Zetia®) or alirocumab (Praluent®).

Ezetimibe is a cholesterol absorption inhibitor. It lowers your cholesterol by reducing the small intestine’s absorption of cholesterol.

Alirocumab belongs to a newer class of injectable cholesterol-lowering medications called PCSK9 inhibitors. These medications act on proteins produced by the liver that are linked to high cholesterol levels.

Pharmacy Care After a Heart Attack

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Medications Used After a Stroke

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Here’s what to know about stroke causes and medications commonly prescribed during recovery.

A stroke disrupts the flow of blood and oxygen to the brain, potentially damaging brain tissue. This can lead to impaired speech, impaired cognitive function, memory loss, numbness, and paralysis.

Strokes can be life-threatening, so it’s important to seek immediate medical care if you exhibit signs of a stroke such as the following:

Sudden numbness or weakness in the face, arm, or leg

Sudden confusion or difficulty speaking or understanding speech

Sudden severe headache without another cause

There are two types of strokes, with different underlying causes:

An ischemic stroke occurs when blood flow to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels. It is the more common type of stroke. Associated health risk factors include high cholesterol, atrial fibrillation, and diabetes.

A hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures, damaging brain cells as a result. Associated health risk factors include high blood pressure and aneurysms.

Additionally, a transient ischemic attack (TIA) — sometimes referred to as a ministroke — occurs when there is temporarily reduced or blocked blood supply to the brain, often as the result of a blood clot. Unlike ischemic and hemorrhagic strokes, a TIA does not result in permanent damage.

Many of the leading risk factors for a stroke are modifiable, including:

Aftercare may include management of these risk factors.

There are a variety of medication classes used during stroke recovery, including the following.

Since high blood pressure is a leading cause of hemorrhagic strokes, stroke recovery may involve the use of several types of blood pressure medications.

Beta blockers cause the heart to beat more slowly and less forcefully, lowering blood pressure. Commonly prescribed beta blockers include atenolol (Tenormin®), bisoprolol (Zebeta®), metoprolol tartrate (Lopressor®), metoprolol succinate (Toprol-XL®), acebutolol (Sectral®), and propranolol (Inderal®).

ACE inhibitors lower blood pressure by blocking production of a hormone called angiotensin II, which causes blood vessels to narrow. Commonly prescribed ACE inhibitors include benazepril (Lotensin®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Prinivil®, Zestril®), and ramipril (Altace®).

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart beats with less force. Commonly prescribed calcium channel blockers include amlodipine (Norvasc®), diltiazem (Cardizem CD®, Tiazac®), nifedipine (Procardia XL®), and verapamil (Calan SR®, Verelan®).

Diuretics lower blood pressure by helping the body get rid of excess sodium and water, reducing the volume of fluid in blood vessels. Commonly prescribed diuretics include chlorthalidone (Thalitone®, Tenoretic®, and Clorpres®), hydrochlorothiazide (HydroDiuril®, Microzide®, and Esidrix®), and indapamide (Lozol®).

Read Common Types of Blood Pressure Medications to learn more about these medications and potential side effects.

Anticoagulants interrupt the body’s natural blood clotting process to prevent new clots from forming and existing ones from growing. The following types of anticoagulants may be prescribed after an initial ischemic stroke.

Warfarin (Coumadin® and Jantoven®) prevents your liver from producing proteins that help form blood clots. It is taken orally as tablets. It has been associated with excessive bleeding in some individuals. Inform your doctor if you have a bleeding disorder so that they can prescribe an alternative.

Direct-acting oral anticoagulants (DOACs) directly block the blood’s ability to form new clots. Commonly prescribed DOACs include apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®).

Read How Anticoagulants Prevent Blood Clots From Forming to learn more about these medications and potential side effects.

Like anticoagulants, antiplatelets prevent blood clotting and may be used during recovery from an ischemic stroke. They prevent platelets from coalescing, targeting a particular step in the formation of blood clots. Clopidogrel (Plavix®) is a commonly prescribed antiplatelet during stroke recovery.

Aspirin may also be used for antiplatelet therapy. If you are taking aspirin, avoid taking other nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, as they may interfere with aspirin’s antiplatelet effect.

Atrial fibrillation, or Afib, is a rapid heart rate caused by irregularities in the heart’s upper chambers. It can lead to the accumulation of blood and the formation of blood clots, increasing an individual’s risk for stroke. (Having other conditions such as high blood pressure, diabetes, or heart failure in addition to Afib may further increase your risk for a stroke.)

There are several medications that may be used to control heart rate and prevent a secondary stroke, including beta blockers, calcium channel blockers, and an antiarrhythmic called digoxin (Digox®, Lanoxin®, Digitek®).

Since high cholesterol may be associated with an increased risk for an ischemic stroke or ministroke, statins — a type of cholesterol-lowering medication — may be prescribed during stroke recovery. Statins act on the liver to reduce the amount of cholesterol produced by your body, in turn preventing plaque accumulation.

Commonly prescribed statins include atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®, Altoprev®), pravastatin (Pravachol®), rosuvastatin calcium (Crestor®), and simvastatin (Zocor®).

Read How to Manage High Cholesterol: Diet, Medications, and More to learn more about these medications and potential side effects.

If you have diabetes, your doctor may revisit your diabetes treatment plan after an ischemic stroke. Individuals with type 1 diabetes require insulin every day to maintain healthy blood sugar levels. Treatment for type 2 diabetes is more varied and may involve insulin, oral medications such as metform, or a combination of both.

A stroke may lead to the loss of bone density. This can increase an individual’s risk for osteoporosis, a condition that weakens bones. After a stroke, your doctor may recommend increasing your intake of calcium and vitamin D — the most important nutrients for bone strength and health — depending on your symptoms.

Treatment for osteoporosis may also include medications such as bisphosphonates, which prevent the loss of bone mass. Commonly prescribed bisphosphonates include alendronate (Fosamax®, Binosto®), ibandronate (Boniva®), risedronate (Actonel®, Atelvia®), and zoledronic acid (Reclast®).

Many individuals experience depression after a stroke, both as a response to the emotional challenges of stroke recovery and due to stroke-induced biochemical changes in the brain.

Medication may be necessary to manage symptoms of depression. There are many types of antidepressants, including:

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac®), sertraline (Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®), venlafaxine (Effexor®), and desvenlafaxine (Pristiq®)

Atypical antidepressants such as trazodone, mirtazapine (Remeron®), and bupropion (Wellbutrin®)

A psychiatrist can recommend the best option based on your particular symptoms of depression, your overall health history, and other medications you’re taking.

Recovery from a stroke is often a gradual process. In addition to taking medication and practicing a healthy lifestyle, your doctor may also recommend speech therapy, physical therapy, and/or occupational therapy.

It’s important to take care of your emotional and mental health. Speak with your healthcare provider about resources that can support your recovery and help you adjust to the changes a stroke may bring. Individual psychotherapy or support groups can be helpful tools.

At Alto, we make it as simple as possible to follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

No industry is immune to burnout, including pharmacy. At many traditional retail pharmacies, individual pharmacists are often asked to do more than is possible on any given workday. Not only does this deprive talented and extensively trained health professionals of a manageable working environment, it deprives patients of the exceptional care they deserve.

pharmacists-spotlight-roni-hein

The better pharmacy model we’ve created at Alto makes life easier for everyone involved in the prescription process: patients, physicians, and pharmacists. And in restructuring how pharmacists work, we haven’t just separated fulfillment and patient care responsibilities into different roles — we’ve ensured that there’s ample support for each specialization, as there should be in any profession.

To wrap up our series of pharmacist profiles in celebration of American Pharmacist Month, we spoke to Roni Hein, a patient care pharmacist lead who takes care of her team so that they can in turn care for patients.

What motivated you to pursue a career in pharmacy?

It all began with my high school and college job at Target. I interacted a lot with the pharmacy team while working in the health and beauty section and eventually moved into that department.

I never expected it to be more than a college job, but it turned into the beginning of my professional path. As I worked there, I was able to see the impact pharmacists made in customers’ lives each day. It really struck me that in many communities, including mine, pharmacists were the most accessible healthcare providers. That accessibility is so impactful on a person’s well-being.

What challenges have you encountered as a pharmacist?

Limited time and isolation behind the counter, without question. In retail pharmacy, more and more responsibilities were added to my job description, with fewer resources to accomplish them.

All pharmacists value the personal connections we make with patients. I think many of us would say that making an impact through patient counseling is the best part of our day, but that is often what gets lost when pharmacists are asked to do more. Our primary driver for entering the profession is the first thing to go. I found a very refreshing change at Alto.

Everyone at Alto, no matter their department or role, has the same shared goal of improving patient lives by transforming the pharmacy model. As a patient care pharmacist lead, I do that by supporting my people. I create the space for our pharmacists to do their best work. They are able to have better interactions with patients because they are taken care of.

The pandemic has been a trying time for many companies and teams, including mine. I am constantly looking for new ways to ward off burnout and maintain a sense of camaraderie, not only for the pharmacists I manage, but for the benefit of our customers as well.

The individual locations of many retail pharmacies can feel very separate from each other. Each one often serves a single population.

The centralization of Alto’s patient care team is a contrast to that model. We have a cohesive, unified team serving all patients. That means there’s a depth of resources available to each pharmacist, which is also really important for retaining great talent.

Our pharmacists have a great support system in their colleagues. There’s other smart, driven pharmacists to bounce ideas off of. Unfortunately, you don’t always get that in our profession.

It also means that you don’t have to worry about anything falling through the cracks if something comes up outside of work. It's a game changer to be able to take time to grieve a loved one or to care for your child if they’re sick while knowing that your patients are still in expert hands. I never had that in retail pharmacy.

Finally, what is one thing people would be surprised to know about life as a pharmacist?

At a tech-oriented pharmacy like Alto where there’s so much innovation, you’re constantly thinking of new and creative ways to problem solve. It’s challenging in the best possible way. There isn’t a day when I don’t have to put my critical thinking skills to use.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. Meet the other pharmacists featured in this series: patient care pharmacist Travis Allison, specialty patient care pharmacist Gabrielle Kaplan, and medication therapy management pharmacist Wei-Lin Chang.

National Pharmacists Month Spotlight: Roni Hein

For many Americans living with a chronic health condition, prescription medications are necessary to manage symptoms and prevent complications. But following a treatment plan can be easier said than done. There are many considerations involved, from managing medication interactions and side effects to staying on track with related testing and follow-up appointments. And of the 66% of U.S. adults who are prescribed medication, only half take their medication as prescribed.

National Pharmacists Month Spotlight: Wei-Lin Chang

At Alto, medication therapy management pharmacists like Wei-Lin Chang help patients navigate all the complexities of managing a chronic disease. As part of our coverage of American Pharmacist Month 2022, we spoke to Wei-Lin about her professional path, the challenges of retail pharmacy, and the importance of medication education.

I honestly didn’t know what I wanted to do when I first entered college. My parents encouraged me to pursue a career in healthcare, but I knew I was a bit too squeamish around needles to become a doctor or nurse.

I took a chemistry class that I really enjoyed and decided to do all the pharmacy prereqs. I then did an internship with the head of pharmacy at Cook County Hospital in Chicago. Through that experience, I saw firsthand that pharmacists were a critical liaison between patients and doctors, with so much valuable information about medication strength, directions, dosing, and administration.

After that, I pretty much knew that pharmacy was for me. I’ve been practicing since 2002.

Before Alto, I worked in traditional retail pharmacy. In that setting, you’re so busy as a pharmacist — it’s one customer after another after another.

I worked both daytime and night shifts, and it was during the night shift, when the store was much more quiet, that I could really counsel patients without feeling so pressed for time. During the day, I simply didn’t have the free minutes to always answer patient questions or give recommendations.

Another challenge I faced was the perception of our profession. At the beginning of my career, in the early 2000s, many people I encountered didn’t know a pharmacist did much beyond putting pills in bottles and handing them off to customers. Not only did this lead to frustration from my customers, who would wonder what we were doing and why it was taking so long, it led to missed opportunities to more actively participate in a patient’s health journey. 

More medication education for patients is an urgent need within American healthcare. People taking multiple medications have to be mindful of potential side effects and medication interactions.

The growing field of medication therapy management is an opportunity for pharmacists to play an even bigger role in patient health, and I’m very proud to work for a company that prioritizes this particular area of pharmacy.

As a medication therapy management (MTM) pharmacist, I contact patients who take multiple medications — often multiple heart medications — and review their entire regimen over the phone. I make sure that they understand the purpose of each medication they’re taking and are on track with related testing.

For example, it’s important to get your liver function checked every 6-12 months if you’re taking cholesterol-lowering medications that are processed by the liver, or to get your A1C levels checked every 3-6 months if you’re taking diabetes medication.

We also discuss side effects, interactions, when to take medication, and what food to take it with. Too often, there isn’t the space for these conversations between pharmacists and patients, but they are so essential to a patient’s overall health. 

I love our pharmacy specializations. It’s unique to have a team that focuses solely on patients and another team that focuses on fulfillment. Not all pharmacies have a medication therapy management program, and it’s possible at Alto in part because of our smart allocation of resources.

Being able to use all of my time to focus on my core job functions is such a contrast to retail pharmacy, where you’re constantly bombarded from all sides at once.

As a pharmacist, what does “care” mean to you?

Care to me means going above and beyond for your patients and making sure all loose ends are tied. As an example, I recently initiated a transfer for one of the heart medications a patient takes. At Alto, we always complete every single step of the prescription transfer process on the patient’s behalf. He was so appreciative, and when I got off the phone, I could tell from his voice that he was smiling ear to ear. That’s the experience I want all of my patients to have.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison and specialty patient care pharmacist Gabrielle Kaplan.

Each October, American Pharmacist Month is an opportunity to not only celebrate the dedication of pharmacists and pharmacy technicians, but also to shine a light on all that they do.

National Pharmacists Month Spotlight: Gabrielle Kaplan

The average American visits a pharmacy 35 times a year, and the availability of pharmacists has the potential to address many gaps within healthcare, like access to the underutilized HIV prevention medication PrEP.

Many people who could benefit from the medication are unable to get a prescription from their primary care provider, whether it’s because they live too far from the doctor’s office or aren’t comfortable speaking about their sexual health. There's growing recognition that expanding the role of pharmacists in HIV prevention can help increase PrEP usage.

At Alto, we’re committed to maximizing the possibilities of pharmacy care. Not only do we divide our pharmacy roles into fulfillment and patient advocacy — we have numerous specializations under the umbrella of patient advocacy that allow our pharmacists to be part of the solution to precisely these healthcare challenges.

As part of our coverage of American Pharmacist Month, we spoke with Gabrielle Kaplan, a specialty patient care pharmacist who makes HIV prevention medication and treatment for complex chronic conditions more manageable for patients.

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